HomeMy WebLinkAboutBUILDING PEMIT APPLICATION :
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f (�
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)452-1578 Commercial Residential v'
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: . '700q 6200AL.tt-re Ayy- F7' 8&94je FL. AgIS t
'Legal Description: 1-07S 13b 4pio 44 I3Lneut 104 1 L.AspuV0011 PWA MNIT 9
Property Tax ID#: - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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AcIditional work to be ve rmed under-this permit-check all appy:
❑HVAC Gas Tank
❑ ❑Gas Piping Shutters
❑WmdawsJDoors
Electric F-1 Plumbing ❑Sprinklers _ enerator
Roof
Total Sq. Ft of Construction: '33010 So. Ft.of First Floor:
Cost of Construction:$ 07000 Utilities: _Sewer❑Septic Building Height:
Name dapiaG.D R So neyati - Name: OWN alt
Address: 07 Vq AN& Company:
City: F! ptegcJ. State: FL
Zip Code: 349S I Fax: r ity:�c}tt,l; ;,:,, 1F
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State:
Phone No. rj ? -'L t � -Ob b G �%p,tC3e `Fcx,
Fax
E-Mail: f��hoohtg,tNos.a , i
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.